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Serum voriconazole

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https://www.readbyqxmd.com/read/29778564/simultaneous-quantification-of-systemic-azoles-and-their-major-metabolites-in-human-serum-by-hplc-pda-role-of-azole-metabolic-rate
#1
Alicia Gomez-Lopez, Laura Alcazar-Fuoli, Leticia Bernal-Martínez
We describe the development and validation of a novel liquid chromatography assay (HPLC/PDA) for simultaneous quantification of voriconazole, itraconazole, and posaconazole, as well as some of their major metabolites, voriconazole N-oxide and hydroxy-itraconazole, in human serum. Analytes were detected using a PDA system that allows the characterization of the specific UV spectra of each compound. The assay exhibited linearity between 0.25-16 mg/L for all the compounds tested. The accuracy and within- and between-day precision of the assay were in acceptable ranges...
April 14, 2018: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/29677084/voriconazole-treatment-for-an-infant-with-intractable-candida-glabrata-meningitis
#2
Sophia Tsakiri, Chiamaka Aneji, Christine Domonoske, Lynnette Mazur, Daniel K Benjamin, Susan H Wootton
We report voriconazole levels in an infant with disseminated Candida glabrata infection who received combination antifungal therapy and rescue voriconazole treatment. Serum and CSF voriconazole levels were higher than anticipated and above target. Dose reduction did not lead to a reduction in the blood or CSF levels. The patient did not exhibit identifiable drug toxicity.
April 19, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29661607/catheter-related-bloodstream-infection-due-to-rhodotorula-mucilaginosa-with-normal-serum-1%C3%A2-3-%C3%AE-d-glucan-level
#3
T Kitazawa, S Ishigaki, K Seo, Y Yoshino, Y Ota
Rhodotorula species are environmental basidiomycete yeasts that have emerged as a cause of fungemia in immunocompromised hosts. The insertion of a central venous catheter was identified as a major risk factor for Rhodotorula fungemia. Few cases reports have reported (1→3)-β-D-glucan testing at the onset of Rhodotorula mucilaginosa fungemia. We report a case of catheter-related bloodstream infection due to R. mucilaginosa. Serum β-D-glucan level was normal at the onset of the bloodstream infection. It took 5 days to culture the isolate...
April 13, 2018: Journal de Mycologie Médicale
https://www.readbyqxmd.com/read/29607966/allergic-bronchopulmonary-mycosis-due-to-schizophyllum-commune-treated-effectively-with-voriconazole-a-case-report
#4
Takashi Ishiguro, Naho Kagiyama, Ayako Kojima, Masami Yamada, Yasuo Nakamoto, Yotaro Takaku, Yoshihiko Shimizu, Kazuyoshi Kurashima, Noboru Takayanagi
A 63-year-old woman presented to our hospital for cough, sputum, and abnormal shadows on chest X-ray. Schizophyllum commune was isolated from mucous plugs. Positive specific IgE and IgG against the fungi, elevated serum IgE, and mucous plugs with typical histologic findings of allergic bronchopulmonary mycosis (ABPM) led to the diagnosis of ABPM due to S. commune. We initially administered itraconazole unsuccessfully. Changing the antifungal agent to voriconazole resulted in improvement of the symptoms and chest imaging findings...
March 30, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29575717/benefits-of-antifungal-therapy-in-asthma-patients-with-airway-mycosis-a-retrospective-cohort-analysis
#5
Evan Li, Chu-Lin Tsai, Zahida K Maskatia, Ekta Kakkar, Paul Porter, Roger D Rossen, Sarah Perusich, John M Knight, Farrah Kheradmand, David B Corry
INTRODUCTION: Fungal airway infection (airway mycosis) is increasingly recognized as a cause of asthma and related disorders. However, prior controlled studies of patients treated with antifungal antibiotics have produced conflicting results. Our objective is to measure the effect of antifungal therapy in moderate to severe adult asthmatics with positive fungal sputum cultures in a single center referral-based academic practice. METHODS: We retrospectively evaluated 41 patients with asthma and culture-proven airway mycosis treated with either terbinafine, fluconazole, itraconazole, voriconazole, or posaconazole for 4 to >12 weeks together with standard bronchodilator and anti-inflammatory agents...
March 25, 2018: Immunity, Inflammation and Disease
https://www.readbyqxmd.com/read/29570914/voriconazole-concentration-is-inversely-correlated-with-corticosteroid-usage-in-immunocompromised-patients
#6
Osamu Imataki, Kazunori Yamaguchi, Makiko Uemura, Noriyasu Fukuoka
BACKGROUND: Voriconazole (VRCZ) is a broad-spectrum antifungal agent that can be administered both orally and intravenously. A high level of intra- and interindividual variability in serum drug therapeutic concentrations has been reported. We analyzed the influence of corticosteroid use on serum VRCZ concentration by assessing the correlation between corticosteroid dose and VRCZ trough level. METHODS: Immunocompromised patients treated with VRCZ with or without corticosteroid use from June 2010 to March 2017 (6 years and 8 months) were reviewed in our institute...
March 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29554829/prolonged-voriconazole-treatment-in-a-patient-with-chronic-lymphocytic-leukemia-resulting-in-a-litany-of-chronic-overlapping-toxicities
#7
Caitlin R Rausch, Dimitrios P Kontoyiannis
Voriconazole is a triazole antifungal with activity against a number of yeast and mold species including Candida, Aspergillosis, Fusarium, and Coccidioides. Invasive fungal infections are associated with high morbidity and mortality, prolonged treatment courses, and occasionally lifelong suppressive therapy. Voriconazole therapy can result in a number of acute toxicities that clinicians are frequently aware of including hepatotoxicity, visual disturbances, and hallucinations; however, there is limited experience with extended durations of voriconazole therapy...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29544767/diagnosis-and-management-of-aspergillus-diseases-executive-summary-of-the-2017-escmid-ecmm-ers-guideline
#8
A J Ullmann, J M Aguado, S Arikan-Akdagli, D W Denning, A H Groll, K Lagrou, C Lass-Flörl, R E Lewis, P Munoz, P E Verweij, A Warris, F Ader, M Akova, M C Arendrup, R A Barnes, C Beigelman-Aubry, S Blot, E Bouza, R J M Brüggemann, D Buchheidt, J Cadranel, E Castagnola, A Chakrabarti, M Cuenca-Estrella, G Dimopoulos, J Fortun, J-P Gangneux, J Garbino, W J Heinz, R Herbrecht, C P Heussel, C C Kibbler, N Klimko, B J Kullberg, C Lange, T Lehrnbecher, J Löffler, O Lortholary, J Maertens, O Marchetti, J F Meis, L Pagano, P Ribaud, M Richardson, E Roilides, M Ruhnke, M Sanguinetti, D C Sheppard, J Sinkó, A Skiada, M J G T Vehreschild, C Viscoli, O A Cornely
The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended...
May 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29491753/voriconazole-poor-oral-bioavailability-and-possible-renal-toxicity-in-an-infant-with-invasive-aspergillosis
#9
Jenny A Walldorf, Omayma A Kishk, James D Campbell, Allison B Lardieri
Voriconazole is the recommended agent of choice for treatment of invasive aspergillosis; however, achieving therapeutic serum concentrations while avoiding toxicity, both with intravenous and oral formulations, is challenging in infants. We report the case of an infant with confirmed invasive aspergillosis who developed renal toxicity possibly associated with IV voriconazole. Renal function improved upon withdrawal of the IV agent and switch to the oral formulation. The infant subsequently required large oral weight-based dosing to achieve therapeutic voriconazole serum concentrations...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29432386/validation-of-a-reversed-phase-ultra-high-performance-liquid-chromatographic-method-with-photodiode-array-detection-for-the-determination-of-voriconazole-in-human-serum-and-its-application-to-therapeutic-drug-monitoring
#10
Ignacio G Bressán, Mariana L Mendez, María I Gimenez
BACKGROUND: Voriconazole is a broad-spectrum triazole antifungal agent. It is widely used in the treatment of invasive fungal infections in immunocompromised patients. Because the pharmacokinetics of voriconazole demonstrates considerable variability, monitoring its serum levels plays an important role in optimizing therapies against many clinically relevant fungal pathogens. The aim of this study was to validate a simple and rapid U-HPLC-PDA method with minimal sample preparation for routine therapeutic drug monitoring (TDM) of voriconazole...
April 2018: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29322720/invasive-aspergillus-pseudomembranous-and-obstructive-tracheo-bronchitis-in-an-immuno-competent-patient
#11
Ramesh S Pal, Sonam Spalgais, Amit Kumar Murar, Umesh Chandra Ojha
A 19 year female, presented with life threatening haemoptysis and cough with minimum expectoration for 3 months. Bronchoscopy showed multiple nodules in airway. The direct microscopy and culture of sputum revealed fungal elements and Aspergillus flavus respectively. Serum Galactomannan was positive. Thus diagnosis of invasive aspergillus tracheo-bronchitis made. She responded to voriconazole. Aspergillus tracheo-bronchitis is a rare form of invasive pulmonary aspergillosis in immuno-competent host. Aspergillus spp in respiratory samples should not be routinely discarded as colonization...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29125713/outbreak-of-invasive-aspergillosis-in-heart-transplant-recipients-the-role-of-screening-computed-tomography-scans-in-asymptomatic-patients-and-universal-antifungal-prophylaxis
#12
Dima Kabbani, Livia Goldraich, Heather Ross, Coleman Rotstein, Shahid Husain
BACKGROUND: Delays in diagnosing pulmonary invasive aspergillosis (IA), a significant cause of morbidity and mortality among heart transplant recipients (HTRs), may impact on successful treatment. The appropriate screening strategy for IA in these patients remains undefined, particularly in the setting of nosocomial outbreaks. We describe our experience employing chest computed tomography (CT) scans as a screening method for IA. In addition, we comment on antimicrobial prophylaxis in HTRs in the setting of an outbreak...
February 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29121264/persistent-cns-toxicity-in-a-patient-receiving-posaconazole-tablets-after-discontinuation-of-voriconazole-due-to-supratherapeutic-serum-levels
#13
Farnaz Foolad, Dimitrios P Kontoyiannis
No abstract text is available yet for this article.
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29049191/significance-of-monitoring-plasma-concentration-of-voriconazole-in-a-patient-with-liver-failure-a-case-report
#14
Xiaoyan Liu, Haibin Su, Jingjing Tong, Jing Chen, Haozhen Yang, Long Xiao, Jinhua Hu, Lina Zhang
RATIONALE: Invasive pulmonary aspergillosis is associated with significant morbidity and mortality in patients with liver failure. Voriconazole (VRCZ) is recommended as a primary therapeutic agent for the treatment of invasive aspergillosis and metabolized in the liver. Now, data are still lacking on the safety and appropriate dosage of VRCZ in patients with liver failure. Here, we report a representative case of invasive pulmonary fungal infection in a patient with liver failure who was treated with low-dose VRCZ...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29026840/impact-of-cyp2c19-polymorphisms-on-serum-concentration-of-voriconazole-in-iranian-hematological-patients
#15
Sholeh Ebrahimpour, Soha Namazi, Mehdi Mohammadi, Mohsen Nikbakht, Molouk Hadjibabaie, Hamidreza Taghvaye Masoumi, Ardeshir Ghavamzadeh
OBJECTIVE: This study aimed to determine the portion of Iranian patients who attain therapeutic serum concentrations of voriconazole (VRCZ) following administration of fixed doses. In addition, the effect of CYP2C19 polymorphism on serum levels of VRCZ was also investigated. METHODS: Forty-eight adult patients of Iranian origin with hematologic malignancies, who received VRCZ for treatment of invasive aspergillosis, were recruited into the study. Blood samples were drawn at day 4 of treatment to measure trough drug concentrations and determine genotyping of CYP2C19 polymorphisms of each patient...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28986123/possible-anti-depressant-effect-of-efavirenz-and-pro-depressive-like-effect-of-voriconazole-in-specified-doses-in-various-experimental-models-of-depression-in-mice
#16
Tejal K Patel, Vandana B Patel, Digvijay G Rana
BACKGROUND: Reports from experimental and clinical studies have indicated the possible relation between cholesterol and depression. Efavirenz (EFV) and Voriconazole (VRC) have been reported to affect cholesterol-24S-hydroxylase enzyme. The objective of the present study was to evaluate the effect of EFV and VRC in experimental models of depression in mice. METHODS: There was a measurement of immobility time in forced swim test and tail suspension test in which mice were previously subjected to the treatment of EFV (0...
May 1, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/28902012/comparison-of-oral-voriconazole-versus-oral-ketoconazole-as-an-adjunct-to-topical-natamycin-in-severe-fungal-keratitis-a-randomized-controlled-trial
#17
Namrata Sharma, Deepali Singhal, Prafulla K Maharana, Rajesh Sinha, Tushar Agarwal, Ashish D Upadhyay, Thirumurthy Velpandian, Gita Satpathy, Jeewan S Titiyal
PURPOSE: To compare the efficacy of oral voriconazole (VCZ) with oral ketoconazole (KCZ) as an adjunct to topical natamycin in severe fungal keratitis. METHODS: Fifty eyes of 50 patients with proven severe fungal keratitis, (>5 mm size, involving >4 mm central cornea and >50% stromal depth), smear, and/or culture positive were randomized to receive either oral VCZ (n = 25) or oral KCZ (n = 25) 200 mg twice a day. Both groups received topical natamycin along with oral medication...
December 2017: Cornea
https://www.readbyqxmd.com/read/28856233/performance-evaluation-of-enzyme-immunoassay-for-voriconazole-therapeutic-drug-monitoring-with-automated-clinical-chemistry-analyzers
#18
Yongbum Jeon, Minje Han, Eun Young Han, Kyunghoon Lee, Junghan Song, Sang Hoon Song
OBJECTIVE: Voriconazole is a triazole antifungal developed for the treatment of fungal infectious disease, and the clinical utility of its therapeutic drug monitoring has been evaluated. Recently, a new assay for analyzing the serum voriconazole concentration with an automated clinical chemistry analyzer was developed. We evaluated the performance of the new assay based on standardized protocols. METHODS: The analytical performance of the assay was evaluated according to its precision, trueness by recovery, limit of quantitation, linearity, and correlation with results from liquid chromatography-tandem mass spectrometry (LC-MS/MS)...
August 2017: Practical Laboratory Medicine
https://www.readbyqxmd.com/read/28835093/voriconazole-refractory-invasive-aspergillosis
#19
REVIEW
Se Yoon Park, Jung-A Yoon, Sung-Han Kim
Invasive aspergillosis (IA) is one of the most common life-threatening complications in immunocompromised patients. Voriconazole is currently the drug of choice for IA treatment. However, some patients with IA suffer clinical deterioration despite voriconazole therapy. Management of voriconazole-refractory IA remains challenging; no useful recommendations have yet been made. Voriconazole-refractory IA can be further categorized as disease attributable to misdiagnosis or co-infection with another mold; inadequate blood voriconazole blood; inadequate tissue drug concentrations attributable to angioinvasion; immune reconstitution inflammatory syndrome; or infection with voriconazole-resistant Aspergillus...
September 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28805964/therapeutic-drug-monitoring-of-voriconazole-for-treatment-and-prophylaxis-of-invasive-fungal-infection-in-children
#20
Sarah Allegra, Giovanna Fatiguso, Silvia De Francia, Fabio Favata, Elisa Pirro, Chiara Carcieri, Amedeo De Nicolò, Jessica Cusato, Giovanni Di Perri, Antonio D'Avolio
Voriconazole therapeutic drug monitoring is not consistently recommended due to its high interpatient and intrapatient variability. Here, we aimed to describe our experience with voriconazole for treatment and prophylaxis of invasive fungal infections in paediatric patients. A fully validated high-performance liquid chromatography-mass spectrometry method was used to quantify voriconazole concentration in plasma, at the end of dosing interval. A high interindividual variability was shown. We enrolled 237 children, 83 receiving intravenous and 154 oral voriconazole...
January 2018: British Journal of Clinical Pharmacology
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